PSEUDO-CONTINENT PERINEAL COLOSTOMY - RESULTS AND TECHNIQUE

Objective : This prospective study was conducted to assess functional results obtained after pseudo-continent perineal colostomy using the S chmidt procedure. Methods : Functional outcome was assessed in 40 pati ents who had undergone amputation of the rectum for cancer and pseudo- continent perineal colostomy reconstruction between 1989 and 1995 in o ur institution. The cancer pathology operative procedure and post-oper ative care were noted. Morbidity, functional outcome and degree of pat ient satisfaction were recorded. Mean follow-up was 45 months (18-87) in 100 % of the patients. Results : There were no operative deaths. Tw enty patients had post-operative complications and 2 patients required early conversion to definitive abdominal colostomy due to severe peri neal complications. Function outcome showed normal continence in 4 pat ients, air incontinence in 23, occasional minimal leakage in 9 and inc ontinence requiring iliac colostomy in 2. Eighty-six percent of the pa tients were highly satisfied or satisfied with their continence capaci ty. Discussion : Pseudo-continent perineal colostomy is a reliable tec hnique which can be proposed as an alternative to left iliac colostomy after amputation of the rectum for cancer if a rigorous procedure is applied : careful patient selection, informed consent, rigorous surgic al procedure, daily life-long irrigation of the colon.